手法治疗在青年股骨头缺血性坏死保髋术后的临床应用

Clinical Application of Manual Manipulation Therapy after Preserving-hip-joint Operation on Ischemic Necrosis of Femoral Head

目的研究关节松动牵拉手法在股骨头坏死保髋术后的临床疗效,寻求保髋术后理想的康复方法,提高保髋治疗效果。方法25例患者39髋纳入研究(青年股骨头坏死保髋术后,坏死灶已清除,术后1年以上,经X线检查股骨头内坏死已修复患者),给予关节松动牵拉手法治疗,15d为1个疗程,疗程间休息3～5d,连续治疗3个疗程;第1个疗程开始前1d和第3个疗程结束后第2d进行评分。观察25例患者39髋治疗前、后关节功能、痛疼程度、优良率,应用Harris评分标准分别对患者治疗前、后状况进行评价。结果治疗前、后患者疼痛指数、关节活动度评定得分间差别有显著性意义(P<0.01)。结论关节松动牵拉手法可改善股骨头坏死保髋术后患者的关节功能,加快肌力恢复,缩短康复疗程,提高保髋治疗效果及生存质量,可望延缓,甚至避免全髋人工关节置换。

Objective To study the clinical effect of manual manipulation after preserving hip joint operation on ischemic necrosis of femoral head （INFH） in order to find an ideal recovery method to improve the curative effect of preserving hip treatment, Methods 39 hips of 25 cases after preserving hip - joint operation on patients with ischemic necrosis of femoral head were treated by the joint manipulation. 15 days was a course, 3 -5 days were the rest time during the course, there were three continuous courses. The estimation time was before the treatment of the first course and on the second day at the end of the third course, The index such as joint function, pain degree and better, good rate was observed before and after the treatment of 39 hips of 25 cases. Harris score criterion was use to estimate the situation of the patients before and after the treatment. Results There was significant diference in pain, joint activity and better, good rate before and after the treatment （ P 〈0.01 ）. Conclusion The joint manipulation therapy can improve joint function after preserving hip operation on ischemic necrosis of femoral head, quicken the recovery of myodynamia, shorten the recovery course, improve the curative effect and life quality, prolong even avoid the artificial joint substitution of the whole hip.